12080030 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20633 GARDENSIDE CIR CWFRACFOR:BRADS]IAW ROOFING INC PERMIT NO: 12080030
OWN'ER'S NAME: WALTER CROCE 1821 S BASCOM AVE 1'JIB 160 DATE ISSUED:08/072012
O\VN'F,R'S 11110NE: 4082469930 C Nl I'll ELI„C\ 95008 PI IONE NO:(108)246-9930
❑ I,ICE.NSE(D�CONTRAC-fQRS� r DECLARATION BUILDING PERMIT INFO: BLDG C- ELECT PLUMB r
License Class. c— —I —l. Lia 'S
a ( { / J b p (+ AIECIr I RESIDENTIAL r COMMERCIALr
Contractor �A!`e_-__ . 4%(��.� f�Odf)ale 2
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE EXISTING ROOF SYSTEM AND INSTALL NEW
CLASS
(commencing with Section 7000)of Division 3 of the Business S Professions A ASPIiALT SIIINGLES, 12 SQUARES
Codc and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the fulliming uvo declarations:
I have and will maintain a certificate of consent m self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of die work for which this Sq.Ft Floor Area: Valuation:$6000
permit is issued.
A I'PI,IC\N'I'CIiR'I'I PICA9'ION APN Number:36232040.00 OccupancyType:
I certify that I have read this application and state that the above information IS
correct.I agree to comply%with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accmc against said City in consequence of the
granting of this permit. Additionally,the applicant miderstmidsmnd will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point sour a re III I'l is per the Cupertino Municipal Code,Section
9.18. 7
Issued by: ��AN �TG� Date:
Signature_ )ate-9/2-62-
❑ OW'NIi12-BUILDER DECLARATION
RF,-ROOFS:
hereby affirm than 1 am exenipt from the Contractor's License Lev for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the follua'ing two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the suucture is not intended or offered for sale(Sec.7044.
Signature of Applicant:
Business&Professions Code)
Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(See.7044,Business fi ProRssions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BE:I-FER
1 hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIA1 S DISCLOSURF-
I have and will maintain a Certificate of Consent to self-insure for M'arker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I Imre read the hazardous materials requirements under Chapter 6.95 of the
perfommnce ol'the work for which This permit is issued. California Health S Safety Code.Sections 2550.5.25533.and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,handlChape
hazarder _and the I material. S
Solely Code.Section 25532(x)should I store or hnndle bmza rdous material.
Section 3700 of the Labor Code,for the performance of the work for%which this Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants its defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of dee work fbrwhich this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health S Safetv Code.Sections 25.505.'_5533.and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the labor Codc.I must `'acT°r m engem:
Dole: a forthwith comply comply with such provisions or this permit shall be deemed revoked.
CON'S'FRIICI'ION I,I'NDING AGENCY
APPLICANTCIS1111 FIC TION
I certifi•that I have read this application mid state that the above information is I hereby affirm that there is it construction lending agency for the performance of cork's
correct.I agree to comply with all city and county ordinances and state Imes relating for which this permit is issued(Sec.3097,Cie C.)
to building construction,and hereby authorize representatives ofthis city to enter Lender'sName
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCIII'1'F,CI`S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
i
Signature Date Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: ojb(p ?, P l l` DATE: 08/06/2012 REVIEWED BY: Beth
APN: BP#: M0 g� 'VALUATION: $6,000
•PERtMIT TYPE: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTiXINIATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK remove existin roofs stem and replace with Class A asphalt shingles
SCOPE
FEE II) ROOF AREA
(s.0
1REROOFFRES 1,200
Meclt. Plan Cheek Plumb. Plan Check Cler. Plan Check
,t tech.Permit Fee: Phunb. Permit Fee: Elec. Perth Fee:
Other Mech. lisp. Ll I Other Plumb Insp. Other Clec. Insp.
Afech. Insp. Fee: Plumb.hup. /vc•: Elea hup. Fee:
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public IWirks, Fire,Sanitary Server District,School
District, etc.). These fees are baser/on the preliminarl•information available and are only an estimate. Contact the De t or addn 7 in o.
FEE ITED'1S (FeeResohuion 11-053E2711111) FEE QTY/FEE MISC ITENIS
Plan Check Fee:
Suppl. PC Fee
Phonb.hllech./Elec
Pennit Fee: $180.00
SuppL Inst Fee
Plumb./Alech./F_lee
Plumb.hblech./F.lec Permii Fee:
Construction Tae:
fl ciminisu•ative Fee:
Work Without Permit? O Yes (F) No $0.00
Ativanceci Planning Fees:
Travel Documentation Fees: �
Strong Motion Fee: 1BEEISHICR $0.60 .Select an Administrative Item
Bldg Stds Commission Fee: 18CBSC $1.00
SUBTOTALS: $181.601 $0.001 TOTAL FEE: 1 $181.60
Revised: 07/01/2012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O.,BUILDING OFFICIAL
CUPEHTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228- FAX(408)777-3333•buildina(akuoertino.oro
PROJECT ADDRESS,x)cO (—/' C C\ APNM !� _3:�_(340
OWNER NAM � �G P O ��� E-MAIL v
r IS 24GY 1
STREET A D SS CI ,ST TE ZIP FAX
3 C r t qS0l
C TRACfO NA. E LICENSE NUMBE LICENSE TYP BUS.LIGM
t i 1
COMPANY NAME E'MAI `- 1 \� Fl -
_7M S3
CITY,STATEZIP 1 ONE
V I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection.
For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Final Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailine Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Pro'eress Inspection is required when approximately 50% of roof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of/4" per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
8. NOTE: _If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be
charged a re-inspection fee of S 126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authnrized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code
Signature of Applicant/Agent: Dater/ -, Q
Lo—
ReroofPolicv_201 lJor revised 02116111
_ - RerwfApp_20!I.aoe revised 03!1611 —